Accelerated Research Pathway (ARP)

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The Accelerated Research Pathway (ARP) is designed to accommodate and encourage candidates who are committed to an academic career as physician scientists with a strong research emphasis in a pediatric subspecialty. This pathway is not intended to be the only route to accomplish such a goal but provides flexibility and additional time for research training during the subspecialty fellowship without lengthening training beyond 6 years. Candidates entering the ARP may begin subspecialty training after completion of 2 years of general comprehensive pediatric training. A structured curriculum and close observation of the progress of the trainee during the core general pediatrics training is essential. The length of subspecialty fellowship will be a minimum of 4 years. The availability of this pathway in any particular program will be at the discretion of the general pediatrics program director/subspecialty fellowship program director. Although it may be advantageous for both general pediatrics and subspecialty training to occur in the same institution, this is not a requirement of the pathway. If training occurs in the same institution, it is advisable for the general pediatrics program director and the subspecialty program director to work in concert to monitor the progress of the trainee.

There will be no specific eligibility criteria with the exception that candidates must be committed to an academic career with a strong research emphasis in a pediatric subspecialty.

Candidates for this pathway should be identified early, preferably prior to the start of the PL-1 year, but no later than 9 months into the PL-1 year. This is necessary so that the second year of training can be adapted in such a way that specified curricular requirements in general pediatrics will be met.

The program director and candidate will not be required to seek prospective approval by the ABP, but must notify the ABP by means of the tracking roster in May of the PL-1 year.

Whether a trainee may remain in the pathway will depend on the assessment of the general pediatrics program director, who will be required to verify competence at the end of 2 years of core training. The program director must be able to attest that trainee performance has been satisfactory and the curricular requirements have been met. The ABP suggests that the program director utilize the In-training Examination results at the beginning of the PL-2 year as a measure of medical knowledge competence. A score at or above the mean for general pediatrics trainees nationwide would provide objective evidence of acquisition of knowledge commensurate with length of training.

TRAINING REQUIREMENTS

Pediatrics Requirements

The training should be the same as described in the ACGME Program Requirements for Graduate Medical Education for Pediatrics as outlined in this document with the exceptions that follow. The curriculum must include 2 years of clinical experiences vacation leave, or other absences from training cannot exceed two months during these 2 years. The clinical experiences should be organized in educational units. An educational unit should be a block (four weeks or one month) or a longitudinal experience. An outpatient educational unit should be a minimum of 32 half-day sessions and an inpatient educational unit should be a minimum of 200 hours.

The specific curricular elements are detailed in the following chart:

Requirements in General Pediatrics for

Training in Pediatrics for those in the Accelerated Research Pathway

(Effective July 2013)

Component

Educational Unit*

Emergency Medicine & Acute Illness

3 (with at least 2 in ED)

Developmental-Behavioral Pediatrics

1

Adolescent Medicine

1

Term Newborn

1

Inpatient Pediatrics (non-ICU)

5 (no maximum)

Ambulatory Experiences to include community pediatrics and child advocacy

**Additional Subspecialty includes 3 units from 3 different subspecialties from the following list:

child abuse

medical genetics

pediatric allergy and immunology

pediatric cardiology

pediatric dermatology

pediatric endocrinology

pediatric gastroenterology

pediatric hematology-oncology

pediatric infectious diseases

pediatric nephrology

pediatric neurology

pediatric pulmonology

pediatric rheumatology

Additional 1 unit of single or combined subspecialties from the list above or below:

child and adolescent psychiatry

hospice and palliative medicine

neurodevelopmental disabilities

pediatric anesthesiology

pediatric dentistry

pediatric ophthalmology

pediatric orthopaedic surgery

pediatric otolaryngology

pediatric rehabilitation medicine

pediatric radiology

pediatric surgery

sleep medicine

sports medicine

Subspecialty Experience

Educational experiences in the subspecialties must emphasize the competencies and skills needed to practice general pediatrics of high quality in the community. They should be a blend of inpatient and outpatient experiences and prepare residents to participate as team members in the care of patients with chronic and complex disorders.

Supervisory Experience

At least 3 educational units of supervisory responsibility must be completed during the 2 years of training

Continuity Clinic

There must be a minimum of 36 half-day sessions per year of a longitudinal outpatient experience in a continuity clinic at a pediatric primary care site throughout the 2 years of general pediatrics training. The sessions must not be scheduled in fewer than 26 weeks per year. The patients should include those previously cared for in the hospital, well children of various ages, and children of various ages with special health care needs and chronic conditions. Residents must have a longitudinal general pediatrics outpatient experience in a setting that provides a medical home for the spectrum of pediatric patients and must care for a panel of patients that identify the resident as their primary care provider.

The medical home model of care must focus on wellness and prevention, coordination of care, longitudinal management of children with special health care needs and provide a patient- and family-centered approach to care.

Individualized Curriculum

There is no expectation of an individualized curriculum, but it is acceptable for a resident to complete electives appropriate for their career pathway.

Subspecialty Fellowship Requirements

Subspecialty training must be at least 4 years in duration and in a discipline for which the ABP requires scholarly activity. The duration of clinical training will be dependent on the pediatric subspecialty. It is understood that a minimum of 1 year of clinical training is required. Some subspecialties of pediatrics may require more than 1 year of clinical training for a fellow to be able to attain the clinical competencies necessary to practice the subspecialty. All subspecialty trainees will be expected to participate in a core curriculum in scholarly activity skills (eg, study design, statistics, principles of evidence-based medicine, manuscript preparation, biomedical ethics, educational techniques). Trainees will be required to meet the same standards for scholarly achievement as defined for those in the standard 3-year subspecialty fellowship training programs.

Eligibility for Certification

To meet the eligibility requirements for certification in general pediatrics, the trainee must satisfactorily complete 2 years of core general pediatrics training and an additional year (1 year of clinical experience) in the subspecialty fellowship. Verification of clinical competence and training will be required from both the general pediatrics program director and the subspecialty training program director.

Eligibility to take the subspecialty certifying exam will require completion of 6 years of total training (2 years of general pediatrics and 4 years of subspecialty training). The subspecialty program director will be required to verify training dates as well as clinical and research competence.